Food allergies abroad

You can eat out safely abroad with a food allergy, but it takes more planning than at home. Carry an allergy card translated into the local language, tell staff about your allergy every time you order, and ask how the kitchen avoids cross-contact. If staff cannot answer clearly, eat somewhere else.

Prepare for the worst case too. If you have been prescribed adrenaline (epinephrine), carry two auto-injectors at all times, know the local emergency number, and know where the nearest hospital is. Allergen rules, ingredients, and language all change when you cross a border, so you need to check for yourself every time.

Before you go: a checklist

• Talk to your doctor or allergist. Make sure your allergy action plan is up to date and that you know how to use your auto-injector. FARE suggests asking for extra prescriptions to carry and learning the generic and brand names of your medicines in each country you visit.
• Carry two auto-injectors. The NHS advises carrying two adrenaline auto-injectors at all times, and Allergy UK says this follows UK medicines regulator (MHRA) guidance. The Government of Canada notes that they may be hard to find in some countries. Check the expiry dates before you leave.
• Keep medicines in your hand luggage, not in checked bags. Allergy UK says you may be asked for proof that you need adrenaline devices, so bring a copy of your allergy action plan or prescription.
• Get the right travel insurance. Allergy UK advises declaring your food allergy like any other medical condition, and checking that the policy covers emergency treatment, ambulance transfers, hospital admission, and replacement medicines.
• Find emergency help in advance. Look up the local emergency number and save it in your phone. Allergy UK also suggests adding your allergies to your phone’s medical ID and pinning the nearest hospital on your map. FARE recommends finding the nearest hospital to where you are staying before you arrive.
• Pack safe snacks for travel days and delays, and check whether your destination limits the food you can bring in.

Use an allergy translation card

A translation card (also called a chef card) is a small card that explains, in the local language, exactly what you cannot eat. It is the clearest way to get your message to the person cooking, not just the person taking your order.

• Where to get one. FARE, a US food allergy charity, offers chef card templates in English and 10 other languages. Allergy UK offers a service that prints cards in your choice of language for a small fee.
• What to include. Name each allergen clearly and say how serious the reaction is. Mention that even small amounts or shared cooking equipment can make you ill.
• Check the translation. FARE notes that its translations may vary with regional dialects. If you can, ask a native speaker to read your card before you travel.
• Carry spares. Bring several copies in case you leave one behind, and keep a photo of the card on your phone.

A simple card might say: “I have a severe allergy to peanuts. Even a very small amount can make me seriously ill. Please make sure my food contains no peanuts or peanut oil, and is not prepared with pans, oil, or utensils used for peanuts. Thank you.”

Know the allergen rules where you are going

In the EU, allergen information is mandatory for food that is not prepacked, including in restaurants and cafes, according to the European Commission. EU law names 14 allergens that must be declared:

• cereals containing gluten (such as wheat, rye, barley, and oats)
• crustaceans
• eggs
• fish
• peanuts
• soybeans
• milk
• tree nuts (such as almonds, hazelnuts, walnuts, and cashews)
• celery
• mustard
• sesame seeds
• sulfur dioxide and sulfites (above 10 mg per kg or liter)
• lupin
• mollusks

In the UK, the same 14 allergens apply. The Food Standards Agency says restaurants, cafes, and takeaways must give allergen information, either on the menu or by telling you how to get it. They do not have to offer you an alternative meal.

Elsewhere, rules vary widely, and there may be no legal duty to tell you about allergens. Local dishes may use allergens you do not expect, in sauces, oils, pastes, or garnishes. FARE also warns that a product sold under the same name in another country may not have the same ingredients.

Even where strong rules exist, mistakes happen. Treat the law as a starting point, not a guarantee.

What to say when you order

Tell staff about your allergy every time you order, even in a restaurant you have used before. The Government of Canada suggests asking for a manager or the chef if needed. Useful questions, based on Food Standards Agency advice:

• Does this dish contain my allergen, including in sauces, stocks, oils, or garnishes?
• Can it be made without it?
• How do you prevent cross-contact? Do you use separate pans, oil, and utensils?
• Has the recipe changed recently?

Choose simple dishes with fewer ingredients. If you are in doubt, do not eat the dish. If staff do not seem to understand your needs, the Food Standards Agency advises that it is best not to eat there.

Our guide on how to choose a safe restaurant abroad covers other signs of a well-run kitchen.

Cross-contact: the hidden risk

Cross-contact happens when an allergen gets into a dish that does not contain it as an ingredient, for example through shared equipment, a shared fryer, or a surface that was not cleaned. The Food Standards Agency notes that heating does not reliably remove allergenic proteins, so cooking or deep-frying does not make a contaminated dish safe.

Busy kitchens, shared woks and grills, and buffets with shared serving spoons all make cross-contact harder to control. Be especially careful at food stalls; our guide on whether street food is safe covers stalls in more detail.

In an emergency: act fast

The NHS lists these signs of anaphylaxis, which usually start within minutes:

• swelling of the throat or tongue
• difficulty breathing, or breathing very fast
• difficulty swallowing, tightness in the throat, or a hoarse voice
• wheezing, coughing, or noisy breathing
• feeling tired or confused
• feeling faint or dizzy, or fainting
• skin that feels cold, or blue, gray, or pale skin, lips, or tongue

What to do, according to the NHS:

1. Use an adrenaline auto-injector straight away if you have one.
2. Call the local emergency number and say you think it is anaphylaxis. In the EU, 112 works everywhere and is free; the European Commission says it also works in some other countries, including Switzerland.
3. Lie down and raise your legs. If breathing is difficult, raise your shoulders or sit up slowly instead. If you are pregnant, lie on your left side.
4. If there is no improvement after 5 minutes, use the second auto-injector.
5. Do not stand up or walk, even if you start to feel better.

Where safeat fits in

safeat shows restaurants where our review found no food-safety concern in the last 12 months. That can help you decide where to start looking, but it cannot tell you whether a particular dish is safe for your allergy. Always check with the restaurant before you order.